Consensus recommendations for diagnosis and management of pulmonary arterial hypertension patients in Egypt

Background The burden of pulmonary arterial hypertension (PAH) in Egypt is quite comparable to the global burden. Nonetheless, there is a lack of clear national guidance on the screening, treatment, and diagnosis of PAH in Egypt. This consensus aimed at summarizing and adapting to the updated guidelines for the diagnosis and treatment of PAH by combining available evidence from the Egyptian practice according to Egyptian experts’ opinions. Methods A three-step modified Delphi method was adopted to develop the present consensus, which consisted of two rounds of voting and in-between virtual meeting. Seven specialized experts from Egyptian PH expert referral centers were invited. Results The consensus provided 71 statements for the screening, diagnosis, and management of PAH, which considered the resources availability and the infrastructure of the healthcare system in Egypt. Besides, the experts highlighted several unmet medical needs pertaining to the diagnosis and management of PAH in Egypt. Conclusion There is a need to establish a national registry that covers all Egyptian PAH centers as well as standardized patients’ databases in these centers. This should be coupled with the development of screening algorithms tailored to the Egyptian setting. To develop such national screening algorithms, cost-effectiveness studies should be conducted in Egypt to better understand optimal screening frequency and the best use of algorithms. Concerning the management of PAH in Egypt, experts emphasized the role of real-world evidence in investigating the current treatment options for PAH in Egypt to improve the understanding of using these therapies in the real world. Likewise, educational programs and workshops should ensure effective physician–patient communication to promote greater patient satisfaction and higher adherence to medications.